U-M Counseling and Psychological Services

Introduction

Understanding exactly what a chronic health condition is can be quite difficult. University of Michigan public health students developed their own working definition:

“A chronic illness is an ongoing physical and/or mental health condition of variable severity that is typically not curable and requires continuous and/or intermittent management from professionals, self, and/or caregivers. The condition may require adaptation and coping to maintain and/or improve functional status and quality of life and may affect and be affected by psychosocial, economic, environmental, behavioral, genetic, religious, sexual, and cultural/racial/ethnic factors.”

As suggested by this definition, a chronic health condition may affect a person’s mobility and independence, change the way a person lives, sees him- or herself, and/or relates to others, as well as challenge one’s ability to complete his or her college degree. In fact, chronic conditions that restrict one’s ability to complete routine physical, social, and academic activities often lead to health related stress and depressive symptoms.

Why Talk about Chronic Health Conditions with University of Michigan Students?

Given that nearly 1 in 2 people have some form of chronic condition and that 60% are between the ages of 18 and 64, it is quite likely that someone you know is living with one. Furthermore, 96% of those chronic health conditions are invisible. So, unless someone tells you that they have an illness, you may not even know they have one.

Depression is one of the most common complications of a chronic illness. Given that college-age students are already at increased risk for mental health disorders and suicide, the following facts are of major concern:

  • About 1/3 of people with a serious medical condition experience symptoms of depression.
  • Depression is 15–20% higher for the chronically ill than for the average person.
  • Chronic illness, particularly uncontrollable physical pain, are major factors in up to 70% of suicides.

Depression is one of the most common complications of a chronic illness. Given that college-age students are already at increased risk for mental health disorders and suicide, the following facts are of major concern:

Loss of a Parent in Childhood

Most clinicians agree that children suffer intense feelings of loss at the death of a parent. In particular, they may turn down the invitation to openly express their emotions about death and loss, and they are likely to behave among their peers as though nothing unusual has happened. The death of a parent has been found to be a risk factor strongly contributing to depression and lowered self-esteem among adolescents and children, and is considered a serious event which, if not addressed, leads to emotional and social disturbance in adulthood. Unresolved grief can impact a college student’s ability to perform academically, may lead to increased risk-taking behaviors (drugs and alcohol intake), and can be a source of depressive symptoms.

Grief and Loss

College Life with a Chronic Health Condition

Living with a chronic health condition and depending on family support can make leaving home for the first time to attend college a uniquely stressful transition. While it is normal to be concerned about the social transition to college, worrying about whether you will be accepted — whether your roommates will judge you because of the way you look, of where you are from, or because of your race or your religious views — living with a chronic condition can add another layer of complexity to social life and academic success.

It is likely that other students may not understand your chronic condition and/or the limitations it has on your ability to participate in common college students’ social activities. The choice to share your diagnosis with your friends and roommates is always yours. If it is something that you would have difficulty hiding, it might be easier to tell people from the start. However, talking about an illness can cause much anxiety for some people, and a therapist or doctor can help you find comfortable ways of disclosing this information.

Chronic Health Conditions and Being Away from Home

But wait, there’s more!

Many University of Michigan students leave behind friends or family members with chronic illnesses when it is time to return to school, and this can be a difficult situation for everyone involved.

Students my feel guilty about leaving other family members or friends with the responsibility of caring for their ill family member (especially if they shared caregiving responsibilities while at home). Functioning day-to-day and maintaining academic excellence may be hindered by continued worry about changes in loved ones’ health or unpredictable emergencies. Students may also need to return home frequently, causing them to miss class and valued social interactions. Restriction of desired normal activities can often result in anxiety, anger, and resentment.

When to Seek Help

If you are having difficulty adjusting to college because you or someone you know is living with a chronic illness, are overwhelmed by caregiving responsibilities, or are experiencing anxiety or depression, tell someone about your symptoms. Talk with someone you trust: a friend, a family member, a doctor, nurse, psychologist, social worker, or religious leader. As a University of Michigan student, you have free counseling services available to you. Asking for help can be difficult and takes courage, but it can make all the difference.